Blower S M, Aschenbach A N, Gershengorn H B, Kahn J O
Department of Biomathematics and UCLA AIDS Institute, UCLA School of Medicine, Los Angeles, California, USA.
Nat Med. 2001 Sep;7(9):1016-20. doi: 10.1038/nm0901-1016.
We use a mathematical model to understand (from 1996 to 2001) and to predict (from 2001 to 2005) the evolution of the epidemic of drug-resistant HIV in San Francisco. We predict the evolutionary trajectories for 1,000 different drug-resistant strains with each strain having a different fitness relative to a drug-sensitive strain. We calculate that the current prevalence of resistance is high, and predict it will continue to rise. In contrast, we calculate that transmission of resistance is currently low, and predict it will remain low. We show that the epidemic of resistance is being generated mainly by the conversion of drug-sensitive cases to drug-resistant cases, and not by the transmission of resistant strains. We also show that transmission of resistant strains has not increased the overall number of new HIV infections. Our results indicate that transmission of resistant strains is, and will remain, a relatively minor public health problem.
我们使用一个数学模型来了解（1996年至2001年期间）并预测（2001年至2005年期间）旧金山耐药性艾滋病毒疫情的演变。我们预测了1000种不同耐药菌株的进化轨迹，每种菌株相对于敏感菌株具有不同的适应性。我们计算得出，目前耐药性的流行率很高，并预测其将继续上升。相比之下，我们计算得出，目前耐药性的传播率很低，并预测其将保持在低水平。我们表明，耐药性疫情主要是由敏感病例转变为耐药病例引起的，而非耐药菌株的传播所致。我们还表明，耐药菌株的传播并未增加新的艾滋病毒感染的总数。我们的结果表明，耐药菌株的传播过去是、而且将来仍将是一个相对较小的公共卫生问题。
